Today’s post is a guest contribution from a Canadian pharmacist who is writing under the pseudonym Sara Russell:
For several years after graduating from pharmacy school, when I’d answer the question “What do you do for a living?”, it would be met with responses like “Good for you!”, “You must be so smart!” or simply “Wow!”. After a decade-long absence from a role in direct patient-care, I returned to pharmacy. I noticed that my response to that same question was met with much less enthusiasm, with some people even having trouble hiding their disappointment. How did this happen? When did being a pharmacist have less caché than saying you worked in a health-food store?
When I began my pharmacy career, so-called natural therapies were very much in the background. I worked in a hospital oncology setting, and observed patients in the waiting room passing around the name of the latest herbal cancer cure. This was before the internet age, so information was passed word-of-mouth, and evidence to support or refute these claims not easy to find. If the oncologist found out, he would usually suggest they discontinue the remedy due to possible interference with their treatment protocol. I don’t think very many complied with this request, and a few admitted to me that they simply would stop telling us. Looking back, this was the genesis of my skepticism. Not wanting them to keep this information from us, I made it my mission to investigate the claims of the various teas and capsules and report the findings back to them. As a relatively new graduate, I embraced the possibility that there was a miracle cure out there and I hoped to be able to find information to confirm their hopes. As I searched, time and time again I came up empty. Strangely, some of the herbs had not even been associated with cancer treatment. I came to realize that the message between patients became like the telephone game I had played so many times as a child.
Fast forward through a decade-long education in drug information, sales & marketing in the pharmaceutical industry, and I now embraced evidence-based medicine as a mantra of sorts. One may think that the term “evidence-based medicine” and pharmaceutical industry don’t belong in the same sentence, but it was there that I learned the art of dissecting research and how to interpret results – a skill that I later realized was used more often to combat competitor’s claims than to support those my own company was boasting of. I became the sales manager’s worst nightmare during training sessions, but my devotion to evidence actually served me well in my sales role as the physicians with whom I developed relationships trusted me. Ultimately, I realized that I was not the right “fit” for a sales role, and my career in retail pharmacy was born.
After 15 years in other settings, I was ill-prepared for what I found on the shelves at my first retail job. What was homeopathy again? Didn’t we learn about that in History of Pharmacy 101? Why is it back again? What was Cold-fX, and why were so many people asking me for it? If I were to be effective in my job I had to find these answers, so I took my drug information skills, and set to work. I signed up for a basic homeopathy course offered by Boiron. I laughed all the way to earning my certificate, which I decided not to print off for display in the pharmacy, as was recommended. Searching less biased sources of information on homeopathy only deepened my feelings of incredulity. The rep for Cold-fX had conveniently dropped off some published studies for me to read. After reading them, I was not only underwhelmed, but wondered how so many other pharmacists could embrace it so enthusiastically. Clearly, they must not have read the studies? Mark Messier and Don Cherry knew better than I did though, so I quickly found out that few patients cared for my opinion. The pharmacy owner encouraged me to adopt the mantra “What’s the harm?” and allow customers to try whatever they wanted as long as there were no obvious risks. Still, I had this nagging feeling that to do so would be unethical, given that there was no real evidence to support their choices.
Then came the great flu pandemic. Patients descended on us suffering obvious symptoms before the vaccine program rolled out and were looking to us for guidance and leadership. Stories about vaccine dangers and conspiracies were swirling among family and friends and spread like another plague on Facebook. Suddenly oscillococcinum was the most in-demand product in the pharmacy, and learning about it ultimately forced me to finally choose evidence over health freedom. Indeed, I now saw its sale in pharmacies as not only unethical, but fraudulent. A skeptic was born.
By pure luck, a pharmacist friend linked to this article on Facebook, which I shared with friends who had irrational fears about the vaccine. Sadly, some responded with their own links to whale.to, Mercola and NaturalNews. My fate was sealed, however, and I decided to make it my mission to educate the misinformed. Daily visits to Science-Based Medicine soon lead me to the blog you’re reading, Respectful Insolence, and Skeptic North. Understanding the difference between evidence-based medicine and science-based medicine completed my evolution. Some friends began to poke fun at how closed-minded I had become. They began embracing “all-natural” lifestyles, embracing acupuncture, and ridding their bodies of toxins with cleanses. I began to realize that I was running up against a mountain when it came to debunking widely-held opinions, and decided to retreat into the valley to regroup. I am not waving the white flag, however, as I am hoping that other health care professionals become more vocal:
Pharmacists, in particular, I call on you to scrutinize new products, dig into outrageous claims, and teach patients the difference between herbal and homeopathic products. Don’t be afraid to comment on articles in our pharmacy publications that are lacking in evidence. Nominate pharmacists for awards that thrive in business with practices such as Schill’s Remedy’s Rx as opposed to those that profit from the Suzanne Somers method of health. Pharmacy students – form skeptical student groups and question evidence presented to you as facts in lectures. Send people to this website to read the many excellent posts written by Scott.
As many people aren’t equipped to interpret science-y information, sometimes I adopt the “fight propaganda with propaganda” routine, and send people to the CBC website to watch a few excellent episodes of Marketplace debunking homeopathy, Cold FX and food labels that appeal to the naturalistic fallacy. While I don’t chase people down who put Stodal into their carts, for those customers that ask for my help, I do provide a quick lesson in homeopathy or in the case of a product like Cold-fX, show them the bottom line on the evidence. In the majority of cases, people feel misled by the hype and walk away $10-$20 richer. Plus, given that many hold the impression that pharmacists only want to sell products, they realize that I can be trusted for honest advice. One customer, a highly-educated well-to-do prominent local woman to whom I’d just explained homeopathy declared “That is something I’d be totally into!”
So I realize I can’t win everyone over, but I can try – one customer at a time.
Next up …. Skepticism in a small town, and why I retreated into the valley – again.